14. Pre-existing Disease Flashcards Preview

Anesthesiology > 14. Pre-existing Disease > Flashcards

Flashcards in 14. Pre-existing Disease Deck (19)
Loading flashcards...
1
Q

Most common heart conditions in dogs and cats?

A

*Mitral regurg in dogs
*HCM in cats
Also DCM

2
Q

Advanced heart failure (stage D) contraindicates anesthesia

T/F?

A

True

3
Q

MVO2?

why do we care?

A

myocardial oxygen consuption

- we don’t want to increase it / Don’t want severe tachycardia

4
Q

Mitral regurgitation main goal?

What type of problem is it?

A

reduce the regurgitant flow

Volume load problem

5
Q

How to change anesthetic plan for mitral regurg

A
  • reduce preload
  • peripheral vasodilation (avoid vasoconstricting drug)
  • avoid depression of contractility
  • prefer higher HR (less time in systole)
6
Q

How to use fluids in mitral regurgitation

A
  • 3-5 ml/kg/hr; don’t bolus

- reduce sodium load, these patients retain sodium

7
Q

How to treat hypotension in mitral regurg patients?

A

CRI dopamine/dobutamine (dopamine also vasodilates)

NOT fluids!

8
Q

meds for mitral regurg

premed
induction
maintenance

A

premed: Ace if needed, opioids

induction:
1. Propofol or Alfaxalone (vasodilation but dec. contractility) Do a combo with benzo.
2. Ketamine
3. Etomidate (gagging, myoclonus)
4. benzo and opioid in depressed patient

maintain - iso

9
Q

avoid ___ and ____ in post-op mitral valve regurg patients

A

hypoxemia, hypercapnia

10
Q

HCM - thickened ________.

A

L ventrical and septum

11
Q

goal in treating hCM pt

A

increase diastolic filling

12
Q

prevent ______ in HCM

A

anterior systolic motion, vasodilation

13
Q

preload?
afterload?
contractility?
in HCM

A
  • maintain preload
  • increase afterload
  • myocardial depression is acceptable
14
Q

drugs contraindicated in hcm

A

ketamine (inc. contractility and HR) Ace, atropine

15
Q

induction in hcm

A

induction:
- propofol with benzo
- etomitate
- benzo and opiod in depressed animals

16
Q

hypotension in hcm

A

not dobutamine bc. inc contractility

use phenylephrine for vasocontriction

17
Q

DCM and pulmonic stenosis are both ____ ____ problems

A

pressure loading (vs. other two were volume loading)

18
Q

DCM
preload?
afterload?
***contractility?

A
  • reduce preload
  • avoid vasoconstriction
  • increase contractility (dobutamine)
19
Q

main goal for dcm

A

maintain and support contractility (dobutamine)